Complex Rhinoplasty

What is a complex rhinoplasty?
A complex rhinoplasty is also known as a revision rhinoplasty. It is done for revision of a primary rhinoplasty which may not have yielded the desired results. As opposed to a primary rhinoplasty, which is a very routine cosmetic procedure, a complex or a revision rhinoplasty requires more precision and dexterity. A revision rhinoplasty is more complex because the surgeon has to deal with the outcome of the previous rhinoplasty and perform one more revision rhinoplasty for the desired functional or cosmetic outcome. In many cases, the primary reason behind a revision a revision rhinoplasty is patient dissatisfaction. So, the patient may want a revision rhinoplasty in case he is not happy with the cosmetic outcome or is facing some medical issue post- surgery.

If a primary rhinoplasty is performed without any pre- operative considerations or an inadequate technique is used, the outcome from the complex rhinoplasty will not be up to the mark. This may mandate the patient to undergo a revision rhinoplasty. Because of the complex consequences of the first rhinoplasty the patients are observed to be very stressed and conscious about their appearance.

Why is a revision rhinoplasty more complex as compared to a primary rhinoplasty?

A poorly performed primary rhinoplasty may complicate any consequent surgeries that may need to be performed on the patient. Sometimes, a revision rhinoplasty may also have to be performed after a person has suffered multiple injuries because of trauma. Trauma intensifies any abnormalities that may be present on the face and this makes the job of the surgeon much more difficult. Some patients may require a revision rhinoplasty after an ill- executed Septoplasty.

The challenges are greater with a revision rhinoplasty because in many cases there is not enough nasal cartilage for the surgeon to work with. So, in a revision rhinoplasty there are aesthetic as well as technical problems. Overcoming the results of the previous rhinoplasty and restoring the nasal area as close to original as possible requires a very experienced and skilled surgeon.

What are the considerations during a revision rhinoplasty?
While performing a complex rhinoplasty, a surgeon takes care of the following points:-
• The structure of the reconstructed nose should be as close as possible to the original nose structure of the patient.
• After the revision rhinoplasty, the overall balance of facial features should be restored.
• Once the revision rhinoplasty is complete, the patient should not face any breathing issue.
• The overall nasal structure should be strong enough to go through the healing period after the revision rhinoplasty.

Use of grafts in revision rhinoplasty:-
The term grafting refers to the procedure in which skin tissues or cartilage are harvested from one part of the body and fixed on to some other part. In a complex or revision rhinoplasty grafts may be harvested from a body part and fixed on to the nasal framework to give it strength and shape. Since our nose is made up of bone and cartilage, the grafts which are used in a revision rhinoplasty are also made up of cartilage which gives support to the complex structure of the reconstructed nose after a revision rhinoplasty. Grafts may be utilized in a revision rhinoplasty through an open or a closed technique. Use of harvested grafts for complex reconstruction of the nose has various benefits. They not only reinforce the structural framework of the nose but they also give more operational flexibility to the surgeon. One of the most common myths in India about use of grafts in a revision rhinoplasty is that the grafts are visible on the surface. The truth is that if the surgeon uses the correct technique, the grafts will be perfectly placed without any visibility.

Grafts which are harvested from ears are known as auricular cartilage grafts. When the auricular cartilage grafts are harvested the shape of the ears does not change. The auricular cartilage can be taken from the anterior or posterior of the ear. For better aesthetic results auricular cartilage is harvested from the posterior so that there is no visible scar in the front. Once the auricular graft is harvested because of the swelling the ear may look slightly protruded. But it returns to normal once the swelling subsides.

Cartilage can also be harvested from the rib for nose shaping. When the ribs are used for harvesting the graft the cartilage is taken and the bones of the ribs are left intact. Harvesting the rib cartilage can be challenging as care has to be taken to avoid damage to the lungs. It requires a highly experienced surgeon to do this job. Choosing a well qualified surgeon for performing a complex rhinoplasty in India is a very significant decision. There are numerous risks associated with a complex rhinoplasty which can be avoided only if the best surgeon is chosen for performing a complex rhinoplasty.

Dr. Debraj Shome who is based in Mumbai is one of the most revered facial plastic surgeons in India who has performed numerous complex rhinoplasty surgeries. He has co- founded The Esthetic Clinics in Mumbai, India which are known for being an outstanding chain of cosmetic clinics in India. Dr. Shome performs many complex and reconstructive surgeries in Mumbai and has dealt with some of the most complex cases in India. The Esthetic Clinics are known in Mumbai for the latest innovations as well as the flawless reputation amongst the patients in Mumbai. If a complex rhinoplasty goes wrong, not only is the patient’s appearance marred it can cause functional issues as well. Due to complex nature of this procedure, the best person to perform a complex rhinoplasty is Dr. Debraj Shome in Mumbai.

If you need a complex rhinoplasty you can visit any one of the multiple branches of The Esthetic Clinics in Mumbai. Dr. Debraj Shome provides personal consultation on appointment for complex rhinoplasty at his clinics in Mumbai. His reputation is unmatched not only in Mumbai but all over in India as well. You can be assured about your complex rhinoplasty if you come to Mumbai to The Esthetic Clinics. The results of a poorly performed complex rhinoplasty can be devastating and to eliminate any scope of further revision, you should visit The Esthetic Clinics in Mumbai. The best results from a complex rhinoplasty are guaranteed by Dr. Debraj Shome.